Provider Demographics
NPI:1891770988
Name:SUAREZ, VICTOR R (MD)
Entity type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:R
Last Name:SUAREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 N OAK ST
Mailing Address - Street 2:DEPT OF MATERNAL FETAL MEDICINE
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:120 N OAK ST
Practice Address - Street 2:DEPT OF MATERNAL FETAL MEDICINE
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521
Practice Address - Country:US
Practice Address - Phone:630-856-2217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-12
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036098580207V00000X
IL36098580207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036098580 / 01Medicaid
IL01621679OtherBCBS OF IL
ILI06690Medicare UPIN
ILK06752Medicare ID - Type UnspecifiedGROUP 950150